Surgery, with Special Reference to PodiatryStern, Maximilian
Science
Surgery, with Special Reference to Podiatry
Stern, Maximilian
Foot -- Surgery; Surgery
Under ordinary circumstances no special constitutional treatment is
necessary beyond that of securing good hygienic surroundings, easily
digested food, restricted at first, and free action of the bowels. If
there is great pain, opiates may be necessary, but here, as in other
surgical indications for anodynes, a minimum amount should only be
given. Usually rest, elevation, and relief of tension will be of
greater benefit than opiates. If there is great restlessness, a
bromide may suffice; if marked insomnia, one of the ordinary
hypnotics. Great restlessness, with excitement and occasional
delirium, without special evidence of pain or infective process, must
call attention to the possible development of delirium tremens from a
relatively slight injury (such as a crushed toe or a simple fracture),
as it may precipitate an attack in one who has been a steady drinker,
though perhaps not an excessive one. In such cases, in addition to the
ordinary therapeutic remedies, the regular administration of whiskey
should be advised.
+TOXEMIA, SEPTICEMIA, SAPREMIA, PYEMIA+
+Toxemia+ applies to the diseases in which one or more poisons are
present in the blood which are not necessarily of parasitic origin and
production.
The word poisons is here used in a broad sense to cover any substance
applied to the body, ingested, or developed within the body which
causes disease. It of course includes ptomains, leukomains, toxins and
sepsins.
Toxemia, according to this definition, would include the diseases due
to poisons not arising from parasitic invasion of the tissues and
fluids of the body, at times of vegetable and alkaloidal nature, such
as strychnine or morphine; of animal origin, such as the toxin of
snake venom, the ptomains of milk or shell fish; then again a mineral
such as arsenic or lead; and lastly the leukomains arising from
disturbed excretion and perverted metabolism and grouped under such
terms as intestinal or uremic poisoning.
+Septicemia+ may be defined as an acute febrile affection, characterized
by marked nervous, cutaneous and visceral manifestations, and due to
the introduction into the system of bacteria and their toxins from an
infected wound. It applies to diseases which present poisons in the
blood that are of parasitic origin, the parasite itself being either
present or absent in the blood. Septicemia, in strong contrast to the
definition of toxemia, would include diseases arising from the
invasion of the tissues and fluids of the body by animal or vegetable
parasites or their poisonous products.
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